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Last Updated: Wednesday, 19 September 2007, 00:56 GMT 01:56 UK
Fracture care overhaul demanded
Osteoporosis
Bone density tests can identify if a person has osteoporosis
The care of people who suffer fractures needs overhauling with the introduction of national screening, experts say.

Doctors said everyone over 50 in the UK who has a fracture after a minor fall should have their bone density tested to see if they have osteoporosis.

The British Orthopaedic Association and the British Geriatrics Society said such a measure would help prevent future fractures, saving the NHS money.

The government said it was investing more in fracture care.

Half of women and a fifth of men have fractures after the age of 50, but the two groups said services were still a lottery.

They said just a third of patients over the age of 65 have DXA scans, a test which measures bone density.

We know the drugs which are available can help reduce the risk of future fractures, so we should be using them
Professor David Marsh
British Orthopaedic Association

Hip fractures are the most serious and complex ones to treat, costing the NHS and social service 20,000 per patient on average.

Some 75,000 people in the UK suffer hip fractures each year - and these are set to double by 2050 with the ageing population, doctors said.

But evidence shows many of these people will have already had other fractures, normally wrists or knees.

The two groups said if patients were regularly tested for osteoporosis their risk of future fractures could be halved with drug treatments.

Professor David Marsh, of the British Orthopaedic Association, said: "The vast majority of people are not being assessed and that is not fair on patients or efficient for the health service.

"We know the drugs which are available can help reduce the risk of future fractures, so we should be using them."

The groups have also called for faster access to surgery following fractures and better auditing of cases and treatments through a national database so performance can be monitored more closely.

'Extra investment'

Pamela Holmes, of Help the Aged, agreed with the call for change.

"When an older person breaks a bone and is admitted to hospital for treatment, it makes absolute sense that they should be tested for osteoporosis.

"It's quite extraordinary that it doesn't already happen."

But Professor Ian Philp, the government's older people's tsar, said steps had already been made to improve care.

"Thanks to recent extra investment in falls and bone health services, we have seen better access to screening for those at risk and faster treatment."

And he added auditing of care had taken place last year and was due to be repeated to keep track of progress and identify where more investment was needed.

And on screening those over 50, he said it would be up to the clinical judgement of doctors.

It comes as research in the New England Journal of Medicine found that a once-a-year drug, Aclasta, cuts the number of deaths among patients with fractures caused by osteoporosis.

Previous studies have also said it reduces the risk of bone fractures.

The drug is expected to receive its licence for use in the UK before the end of the year.


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